Ketamine for Severe Asthma Exacerbation

Area of Science:

• Critical Care Medicine
• Pulmonology
• Pharmacology

Background:

• Severe asthma exacerbations (SAEs) often require mechanical ventilation.
• Continuous infusion ketamine is used in intensive care units (ICUs) for various indications.
• Limited data exists on ketamine's impact on gas exchange in intubated SAE patients.

Purpose of the Study:

• To assess the effect of continuous ketamine infusion on Pco2 levels in intubated patients with SAEs.
• To evaluate changes in pH, ventilator requirements, and safety outcomes.
• To determine if ketamine improves gas exchange during severe asthma exacerbations.

Main Methods:

• Retrospective observational study of 38 intubated patients (≥18 years) with SAEs.
• Patients received continuous ketamine infusion for ≥1 hour.
• Primary outcome: change in Pco2 before and after ketamine initiation.

Main Results:

• Median Pco2 was 67.65 mm Hg before and 64 mm Hg after ketamine (p-value not specified).
• Median pH increased slightly from 7.21 to 7.24.
• Adverse events included tachycardia (52.6%), hypotension (50%), and emergence reactions (13.2%); mortality was 15.8%.

Conclusions:

• Continuous ketamine infusion did not significantly improve Pco2 levels in intubated patients with SAEs.
• Ketamine use was associated with significant rates of tachycardia and hypotension.
• Further research is needed to clarify ketamine's role in managing severe asthma exacerbations.